The short version:
Unknowingly this started after Lydia was born in October 2010. Turns out I had placenta accreata, which resulted in retained placenta and significant bleeding following delivery (we still don't know why I even had the accreata). This required initially an extensive manual placental removal, followed by a D&C (dilatation & curettage) for retained products in early November of 2010. Since then I had never resumed menstrating. This was initially attributed to the fact that I was breast feeding and not considered abnormal. Since I also have PCOS that too could have been contributing. But we wanted another baby, so I weaned & restarted Metformin (helps some women with PCOS have regular cycles) which I was on before our first pregnancy. Several months later still nothing. My OB/GYN considered a variety of reasons and ruled out by lab work any other contributing factors. He prescribed a number of cycles of medications so we had to wait month by month for something to happen. After some time of still nothing, he was more concerned I could have a problem related to the complicated delivery, and the referrals began.
The specialist we saw first was immediately suspicious of intrauterine adhesions (IUA) - also known as Asherman’s syndrome. My uterus might be broken - that is how we saw it. He laid out all for us what this meant, including potentially not being able to carry any more pregnancies if severe enough. We did an US that day which identified a small area of normal endometrium, so at least we had something to work with! I was started on estrogen to help heal & grow any normal tissue areas. We could only wait again until the next month when another US was done - which identified the area of normal endometrium, slightly increased and with potentially some trapped blood/fluid. All of these things were good signs! Our doctor tried to do a hysteroscopy in the office to access the "good spot," however the adhesions were too dense and would require a more aggressive approach. Therefore I underwent US guided operative hysteroscopy a week later.
The week leading up to that procedure was the first time in quite a while I started to imagine being pregnant again - I thought we could make plans, daydream about names, the timing of maternity leave, should we find out boy or girl this time around - essentially being hopeful and happy to get past all the waiting and procedures. I was excitedly anxious wheeling back to the OR.
Unfortunately at this procedure our doctor discovered the scarring was much more severe than expected. He was not able to get into the normal area previously identified. He wasn't able to place the balloon that would help it heal normally. I didn't need to take any more of the medications he had prescribed. I didn't need to come back into the office as previously scheduled. I could consider seeing someone else, but he did everything he could that he was comfortable doing. Definitive - my uterus is broken.
The week leading up to that procedure was the first time in quite a while I started to imagine being pregnant again - I thought we could make plans, daydream about names, the timing of maternity leave, should we find out boy or girl this time around - essentially being hopeful and happy to get past all the waiting and procedures. I was excitedly anxious wheeling back to the OR.
Unfortunately at this procedure our doctor discovered the scarring was much more severe than expected. He was not able to get into the normal area previously identified. He wasn't able to place the balloon that would help it heal normally. I didn't need to take any more of the medications he had prescribed. I didn't need to come back into the office as previously scheduled. I could consider seeing someone else, but he did everything he could that he was comfortable doing. Definitive - my uterus is broken.
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